Transition towards autonomy and psychological empowerment in self-management, among teenagers with type 1 diabetes

Abstract: The general aim of this thesis was to study the transition process from dependency towards anatomy and psychological empowerment among teenagers with type 1 diabetes. Thirty-two teenagers (18 female/14 male) aged 13-17 took part in conversational interviews. The interviews followed a semi-structured question guide. Data comprised 31 tape recorded interviews (one informant did not want to be tape recorded). The research design was based on a phenomenological and life world perspective including two different analysis methods.The transition towards autonomy among teenagers with type 1 diabetes was elucidated in a phenomenological approach (paper I). Through the teenagers’ narratives about their daily life experiences with type 1 diabetes there emerged the over-riding theme “Hovering between individual actions and support of others”. This theme illustrates the main problem related to diabetes management - duality in dependence and independence. The themes “growth through individual self-reliance” and “growth through confirmation of others” seem to facilitate the transition process from dependency towards autonomy. Experiences of the Empowerment Education Programme (EEP) were studied by a qualitative content analysis (paper II). From the teenagers’ descriptions the over-riding theme was formulated as “Sense of community”, and this covered the categories of social fellow feeling, collaborative learning, and community of interests. A synthesis of the findings illustrates that individual self-reliance, confirmation of others, and sense of community are closely related to individual inner resources, trust in others, and the feeling of belonging, which are all suggested as specific goals of empowerment and fulfilment of psychological empowerment. A model was created to explain the relation between psychological empowerment and growth through individual self-reliance, confirmation of others, and sense of community. Professional nursing care might start from the unique situation and context the individual experiences and exists in. Social meetings with like-minded youth were highly appreciated among the teenagers. The teenagers showed their willingness to transform themselves towards becoming more independent in self-management, and the teenage years may be the right period to empower and coach the teenagers towards autonomy and prepare them for adulthood living with type 1 diabetes.